Dental needs change through the different decades of life.  They reflect the stages of health and lifestyle.  To meet the needs of maintaining proper dental health in all the stages of life requires homecare, diet control and regular dental office visits. Regular visits to the dentist will help guide homecare as oral health changes.

The first two decades of life and dental health care pertain to prevention of decay, prevention of trauma during activities like sports, and orthodontic care for proper tooth alignment.  Early orthodontic care can establish a healthy airway along with providing a beautiful smile. Decay prevention is mainly a diet and homecare issue.  Regular visits to the dentist will help reinforce healthy habits, homecare and diet, strengthen teeth with fluoride applications and catch any problems early, but the overriding responsibility for maintaining  good oral health is what is done on a daily basis at home with diet, hygiene, and safety.  Wearing an athletic mouthguard during sports is essential even if the sports league does not require mouthguards. Wearing one can prevent tooth damage, tooth loss and concussions. 

In the third decade, things tend to be pretty stable during this peak health phase of life.  As long as good care was taken during the first two decades and is continued, not much happens.  In the fourth and fifth decades there starts to be some other needs and changes.

In the fourth and fifth decades there may be some changes, periodontal (gum) recession, straight teeth getting crooked, a cavity or two, a broken or cracked tooth and some old restorations may need replacement.  Gum recession is most often due to previous orthodontic treatment and/or brushing against the gums too hard.  Orthodontic retreatment is very common in middle age due to crowding as a result of not wearing orthodontic retainers and not getting new retainers on a regular basis.  When people are in peak health they sometimes choose to not go to the dentist regularly, are lax in their homecare and diet. New cavities may develop during this time due to bad habits that carried over from the twenties and thirties. Normal wear and tear can also lead to the breakdown of teeth and old restorations but most breakdown happens due to bad habits, like ice chewing, and clenching and/or grinding.  Cracked teeth need treatment, a crown, onlay or extraction.  A common way to replace missing teeth is with dental implants.

In the sixth decade and beyond, any unresolved issues of the previous decades carry over. In addition to natural wear and tear, many people develop dry mouth and may start to develop some arthritis or limited dexterity impacting how well teeth are brushed.  As we age, our saliva production decreases.  Some medications can also cause dry mouth.  Reading the side effects of many medications reveals that dry mouth is a common side effect.  Dry mouth is a major contributor to the overgrowth of bacteria that cause decay, gum disease, and fungal infections.  Limited dexterity due to arthritis and hand or arm injuries can make homecare more difficult.  Hygienists can instruct patients how to maintain health when there are health challenges like arthritis.  Staying well hydrated and keeping up with homecare and dental visits is essential.  In these decades it may be recommend to have more frequent dental care visits and recommended to use different homecare products, like a special toothpaste and/or mouth rinse.

The good news is, with good health, proper homecare and regular dental visits, many more complicated issues can be avoided or they will have limited effect on day to day life.  Start early and stay engaged in healthy habits.

Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, visiting faculty at Spear Education, alumnus of Pankey Institute, Qualified Invisalign provider, member of the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association.  Dr. Gallegos practices dentistry in Middleburg, VA.

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